Facial skeletal changes following hypertelorbitism correction.

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Pediatric Orthodontics

Background:

• Hypertelorism, a condition characterized by an increased interorbital distance, often requires surgical correction.
• Skeletal stability and long-term outcomes following hypertelorism repair are critical considerations for patient management.

Purpose of the Study:

• To evaluate skeletal changes and long-term outcomes in patients who underwent surgical correction for hypertelorism.
• To identify factors influencing the stability of orbital translocation and identify potential complications.

Main Methods:

• Retrospective analysis of 19 patients with corrected hypertelorism.
• Assessment of interorbital distance, relapse, and other skeletal changes at various postoperative intervals.

Main Results:

• Favorable outcomes (relapse < 5 mm) were associated with initial interorbital distances of 32 mm, while distances of 40 mm tended to relapse.
• Age, interorbital configuration, and diagnosis did not significantly affect the stability of orbital translocation.
• Mean interorbital distances at long-term follow-up were 22.4 mm (favorable) and 28.3 mm (unfavorable).
• Resorption of the reconstructed nasal complex was noted as a long-term skeletal problem.

Conclusions:

• The standard hypertelorism operation may negatively impact anterior facial growth, suggesting delayed surgical intervention for mild cases until late adolescence.
• For severe cases in young children, procedures like nasoethmoidal resection, transmaxillary osteotomies, or facial bipartition may be indicated.
• Understanding the technical and biological factors contributing to nasal complex resorption is crucial for improving surgical outcomes.